Title: A Survey of Female Plastic Surgeons’ Attitudes ...



Title: A Survey of Female Plastic Surgeons’ Attitudes toward Breast Reconstruction

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Authors: Susan Downey MD, Cheryl Morales BSN, RNFA

Background: Breast cancer affects one in seven women every year. These patients go through a maze of decisions to whether they will opt for breast conservation or will choose a mastectomy with reconstruction. Patients rely on surgeons for guidance and often ask the surgeon which option they would choose if they were the patient. Studies have been done of patient satisfaction regarding their method of reconstruction but no studies have been done as to physician preferences regarding type of reconstruction. This study was designed to explore the opinions of female plastic surgeons regarding breast reconstruction.

Method: A questionnaire was developed for this study to inquire about female plastic surgeons preferences for breast reconstruction if they were to be diagnosed with breast cancer.

Results: At the 2003 ASPS meeting 54 female plastic surgeons attending the Women’s Plastic Surgeons luncheon were polled by questionnaire as to the method of breast cancer treatment they would opt for if they were diagnosed with breast cancer. The majority (49/54 or 91%) stated that they would opt for mastectomy rather than undergo a lumpectomy and radiation. Only two (2/54 or 4%) would opt for mastectomy without reconstruction. For their reconstruction choices 29 female plastic surgeons (29/54 or 54%) would choose tissue expansion with implant and 15 (15/54 or 28%) would choose a tram flap. Only three (3/54 or 5%) would opt for a latissimus flap if all methods of reconstruction were available to them. For the women choosing implant reconstruction 23 (23/29 or 79%) would choose a silicone implant, 7 (7/29 or 24%) would choose a saline implant while one respondent felt either type of implant would be acceptable. The most frequently chosen reconstruction was tissue expansion followed by a silicone implant (23/54 or 43%).

Conclusion: Female plastic surgeons offer a unique insight into surgical outcomes following breast reconstruction. The Tram flap has been considered the Gold Standard for breast reconstruction, it is interesting the female plastic surgeons with their knowledge and experience with the various reconstructive methods used for breast reconstruction would choose tissue expander reconstruction. These reasons should be further explored.

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